CPR by paramedics saves almost as many elderly heart-attack victims as it does younger ones, and should not be abandoned for older people in an effort to eliminate useless procedures, a study concludes. Some previous research of cardiopulmonary resuscitation has suggested the elderly may derive negligible benefit from attempts to revive them after out-of-hospital cardiac arrests. Survival rates in those studies were as low as 1 percent.
But a five-year study in Seattle showed that 10 percent of cardiac-arrest patients over age 70 who received CPR from paramedics survived not only long enough to get into the hospital, but also long enough to go home. That compared with a 14 percent survival rate in younger victims.
In the study period, which ended in March 1988, paramedics treated 1,407 out-of-hospital cardiac arrests among people age 70 or older, and 27 percent of the victims lived long enough to get admitted to a hospital.
During the same period, paramedics treated 1,624 younger patients for out-of-hospital arrests, and the survival rate to admission was 29 percent, said researchers led by Dr. W.T. Longstreth Jr. of Harborview Medical Center in Seattle.
A total of 140 elderly patients survived after being released, as did 223 younger patients, the researchers reported in Wednesday's Journal of the American Medical Association.
Paramedic CPR worked best on heart attacks marked by ventricular fibrillation, a rapid, uncoordinated and ineffective heartbeat caused by haywire electrical impulses in the lower heart chambers, the researchers said.
The study's conclusions don't apply to patients who have heart attacks inside hospitals because those patients are much more likely to have other illnesses that reduce survival.